Healthcare ethics consists of numerous complex cases, such as the one presented in the story of Breeze, and they are handled with a high degree of multi-directionalness, which is an endeavor of compassion, professionalism, and the observance of ethical standards. This case provides a multidimensional view of the subject area, where a boy aged 13 is suspected to be in a sexual relationship, and he is found to be favorable to that STIs thus patient autonomy must be always put into concern. This case brings to the fore the actual scenario of the same concerns, where the healthcare is a source of abuse, consent, and decision-making of the teen.
For example, Breeze condition deals with several significant problems viewed from a nursing perspective, including clinical, societal, and ethical components. First, the health professional’s failure to provide Breeze immunizations or physical exams after high school transitioning indicates a profound problem in healthcare. Immunization probably is the best way to protect Breeze from ensuring his health and from the spread of contagious diseases to his classmates, which is another reason why they are so important. Apart from that, the lack of physical exams naturally surpasses some preventive health measures, such as screenings for possible health issues and the chance to treat existing medical conditions in the development stage. In accordance, the assistant professor ought to express concerns related to personal and ethical aspects, mainly fear of sexual abuse and violence between individuals (Lund et al., 2020). Breeze’s disclosing pain and itching in his egg sac, positive STI results with syphilis and gonorrhea incline the thought of if he had been concerned rather abused of sexuality or exploitation. This very case brings out to the daylight an important social issue which deals with students’ security and health.
Secondly, the presence of linear bruises on Breeze’s buttocks and thighs is another crucial factor to take into consideration while conducting the investigation process. The presence of these bruises shows there must have been some physical abuse or neglect, which makes Breeze’s continued vulnerability glaring and highlights systemic failures in care and support. The nurse deals with a question of ethical standards as the report of suspected abuse takes precedence over Breeze’s autonomy and privacy, yet the dilemma is giving her a hard time. The lack of adequate care for these issues will not only make the dangers continue but will also make a dent in the primary objective of nursing, which is the safety of the patients and their well-being.
The moral predicaments Breeze encounters do not leave me indifferent. I feel appalled and morally bothered. Seeing a fellow like Breeze confronting large-scale social inequity and exploitation as a healthcare provider is truly painful. Refusing the administration of needed immunizations and health care services due to the opposition on the part of the parents highlights an ethical dilemma of what is more critical: autonomy or the child’s welfare. On the other hand, noticing any signs of possible sexual abuse apart from Breeze’s initial refusal to talk about the matter engender a feeling of helplessness and frustration on my part with the systemic obstacles to the protection of the vulnerable due to the breach of confidentiality. However, the feelings harbored toward Breeze to help and to speak up for him become the battle zone of his satisfied safety while the legal and procedural limitations cease the immediate response. On the top of that, the moral stress evolves, in manifestation of a strong conviction and an unbreakable need for ‘Breeze’ to be supported and justice served for him.
What unfolds in this situation is that the power disparity, financial imbalances, ethical dilemmas, and value divergence among all the key players emerge. Initially, people tend to draw the undeserved conclusion that Breeze’s parents are involved and proficient enough to offer adequate healthcare for their child in place of their obvious negligence. This assumption highlights the power inequality that is present in this parent-child relationship, as these parents who have the legal power over Breeze’s healthcare decisions cannot be trusted but yet failed to take the responsibility of ensuring that he has his immunizations and is healthy. Another area of disparity is financial imbalance, which is seen in Breeze is not having access to healthcare services, such as vaccinations and a physical examination, which represents the disparities in the affordability and availability of healthcare services (Majumder et al., 2023). The condition becomes more unbalanced with the perspective of parents who should permit immunizatforn, as it would be the legal demands not the nee,ds of Breese on immediate baan sis. Nevertheless, competing loyalties appeared in the the security and autonomy of Breeze vs. the hospital clinical system, remained consistent with parental consent regulations. This strife brings to light competition between patient advocacy and institutional policies that may require that legal compliance is prioritized over patients’ well-being.
At the same time, sexual abuse suspicion raises an ethical dilemma for clients’ data protection and adult care duty realization, which would require the nurses to report the suspected offense to Child Protective Services if a nurse is assigned to adults. Breeze’s resistance to providing information adds another layer to this disturbance, as it contradicts the nursing authorizes to protect the patient from risk connected with respecting the patient’s autonomy. Therefore, the unspoken assumptions and power imbalances, the financial inequality, and the shared but sometimes conflicting values are embedded in the comprehensive challenge of giving ethical and equitable healthcare to vulnerable individuals such as Breese, which institutions face in providing healthcare within the boundaries of their policies and laws.
The information sources for Breeze are at least somewhat limited. Therefore, a complete knowledge of his health condition and its resulting factors is impossible. Moreover, there needs to be a specific discussion concerning Breeze’s family relationship patterns, which may include his parents, parental care, and other factors that, in some cases, may keep them busy or might hinder them from giving him any needed attention. Breeze and his family will be interviewed to obtain this relevant information, and collateral information from other caregivers will also be helpful. Also, there is a lack of information about Breeze’s medical activities, like what previous healthcare encounters he has had, chronic illnesses, and if he has developed any developmental issues. Accessing the medical records from Breeze’s previous doctors is one of the options. The other is a detailed conversation on her medical history. Besides the fact that there is seemingly not much information about Breeze’s social surroundings with his peers and the support systems, he has also yet to be cataloged, such as his current living situation, association with the peer group, and his classification with the community he belongs to.
Getting information from school personnel, mass media, and the Breeze’s social network will help us understand the social context around the character. First, there is confusion regarding Breeze’s health history, especially on the exact time of developing his symptoms whe,ther the injuries were a result of abuse by a stranger, acquaintances, or family members, and if he has suffered any previous repeated or singular sexual abuse or has ever disclosed the issue to an adult. Undertaking an expansive sexual wellness analysis, which will require documenting symptom status in detail as well as potential risk elements, could serve to clarify this information. Moreover, the story has clearly brought out the lack of information Breeze requires on whether he understands his medical condition, his choice of treatment and disclosure, and the obstacles facing our healthcare system. The conversation with Breeze should be conducted in a friendly and understanding manner. The vocabulary should also be appropriate for thechild’s aged and the communication method should be adapted depending on thechild’s abilityd. Through talking about these areas this way, it is possible to make an investigation in to them. Alongside, it is crucial to provide more details on the legality and morality of Breeze’s medical care, such as the scope of mandatory consent policies for medical procedures, the procedure for reporting tempting abuse, and the offers for obtaining support services. It would be wise for universities to check whether institutional regulations, legal experts, and ethical norms address the linked concerns. Therefore, prerequisites for successful resolution of the identified information gaps are multidisciplinary approach, characterized through the collaboration between health care agencies as well as social workers, legal professionals and local resources so as to come up with an approach that takes into account all Breeze needs.
The stakeholders engagement is two fold. They are not all homogenous, each with individual role and interest. Initially, the key stakeholder involved is Breeze, a teenager that needs healthcare services. Breeze’s family members which include his parents and even guardians are likewise stakeholders because they are responsible for the upbringing of the person and they are the ones who make the decision regarding his healthcare treatment. The clinic and its staff, including RNs, NNPs, and physicians that accommodate Breeze in this healthcare shingle are stakeholders that provide medical services diagnose diseases, and coordinate care. In addition to physicians, registered nurses, nutritionists, and pharmacists will access Breeze’s situation and sort out the emotional and social problems that she faces. Along with that, Child Protective Services (CPS) is a key stakeholder in the process of investigations of suspect child abuse and safety of Breeze and her well-being(Slack & Berger, 2020) has been investigated. Also, stakeholders might invest in the resources that the local community may have including advocacy groups of victims of violence and support services. They will provide the Breeze Family with more support and assistance.
In the scenario Breeze may have to cope with a variety of challenges which can include cultural, language, religious and healthcare literacy barriers and may have significant influence on the quality of care that her patient receives. Cultural differences can alter Breeze’s perception concerning the healthcare system, the way she can get to certain topics connected with sexual health such as abuse, for cultures may stigmatize these topics or may consider that private ones shouldn’t be discussed openly. Language obstacles also serve as one of the factors that might inhibit meaningful communication between Breeze and the healthcare providers, particularly if Breeze or his family members primarily speak a language other than English or they simply do not understand the English instructions and cannot express concerns. Moreover, religious thoughts have got the chance to drive healthcare decision, for instance looking for alternative treatment methods or relying much on prayer to recover which may contrast evidence based medical advice. Healthcare literacy obstacles that include a basic understanding of medical terminology or procedures could then pose a more complex problem as to how Breeze accesses the medical system and sticks to treatment plans. These obstacles further highlight the need for culturally competent care, translation services and patient education, all developed around Breeze’s cultural orientation, preferred language, and level of health literacy to bridge the gap of information and assure him a receiving much-needed care and proper support.
The compassionate route of action for the case of Breeze needs considering the present health issues and his security while the occurrence of the sexual abuse remains unclear. Primarily, the healthcare folks should focus on arrange appropriate treatment for Breeze STIs comprising syphilis and gonorrhea with the objective to relieve his symptoms and eradicate the risk of further complication(Bowen, 2020). These include the administration of relevant antibiotics and ensuring good supportive care to manage any pain or disadvantageous effects associated with the treatment.
In addition, the medical team have to comply with the legal and ethical regulations regarding mandatory reporting about possible exploitation or neglect of the minor to the local Child Protective Services (CPS), to trigger an investigation and provide protection to Breeze. This entails writing detailed description and findings including Breeze’s own disclosure of pain and itching in his bottom and straight-line bruises that appear as blunt trauma indications to support the clinicians suspicion of sexual abuse. Also they should be ready and willing to construct and support an environment which will enable Breeze to fulfil his needs. These could require social workers, psychologists, child advocacy employees and much more to produce a comprehensive support for Breeze and his family during this hard period(Wald, 2020). Environmental, besides that the staffing should also focus on Breese’s privacy and confidentiality while at the same time interconnecting it with open communication towards his family and other stakeholders whose concerns must always be at the core of decision making (Rukhsan Islam et al., 2022). In the last stage, healthcare professionals must be at the forefront of policies and practices aimed at infants and children abuse and neglect prevention and advocating for their services in the community and healthcare system by taking care of education and training programs professionals, mandatory reporting, and have an access to support services for the affected individuals and families(Nouman et al 2020). These ethical actions will assist the healthcare personnel in fulfilling their obligation to strive to attain appropriateness and responsiveness to the patient’s needs. Besides, the healthcare team will be a guardian of the patient’s rights and safety in the sphere of suspected child abuse.
In conclusion, resolution of Breeze’s case multipronged approach involving his speedy treatment, safety and take care of his well-being. Appropriate Medical Treatment, including STIs, is necessary with the initiation of reporting suspected sexual abuse to Child Protective Services. Whereby, the health team can fulfill their duty to protect Breeze from further harm and provide resources that will aid Breeze in navigation of the challenging situation. Moreover, the mandate of creating open dialog, keeping Breeze independent, and opening for procedures and policies intended for child abuse and neglect prevention and treatment will definitely help to outline the ethical course of action in this particular case. Through the observance of moral procedures and principles, it is possible for the health care team to fulfill their obligations in terms of safeguarding the health and integrity of all the individuals under their supervision which in turn contributes to the over well-being of Breeze and other less fortunates.
References
Bowen, E. (2020). In Search of Sexual Health: Diagnosing and Treating Syphilis in Hot Springs, Arkansas, 1890–1940. Johns Hopkins University Press. ISBN-13978-1421438566
Islam, M. R. R., Islam, R., Ferdous, S., Watanabe, C., Yamauti, M., Alam, M. K., & Sano, H. (2022, August). Teledentistry as an Effective Tool for the Communication Improvement between Dentists and Patients: An Overview. In Healthcare (Vol. 10, No. 8, p. 1586). MDPI. https://doi.org/10.3390/healthcare10081586
Lund, R. G., Manica, S., & Mânica, G. (2020). Collateral issues in times of covid-19: child abuse, domestic violence and femicide. Revista Brasileira de Odontologia Legal, 7(2). https://doi.org/10.21117/rbol-v7n22020-318
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Nouman, H., Alfandari, R., Enosh, G., Dolev, L., & Daskal-Weichhendler, H. (2020). Mandatory reporting between legal requirements and personal interpretations: Community healthcare professionals’ reporting of child maltreatment. Child abuse & neglect, 101, 104261. https://doi.org/10.1016/j.chiabu.2019.104261
Slack, K. S., & Berger, L. M. (2020). Who is and is not served by child protective services systems? Implications for a prevention infrastructure to reduce child maltreatment. The ANNALS of the American Academy of Political and Social Science, 692(1), 182-202. https://doi.org/10.1177/0002716220980691
Wald, H. S. (2020). Optimizing resilience and wellbeing for healthcare professions trainees and healthcare professionals during public health crises–Practical tips for an ‘integrative resilience’approach. Medical Teacher, 42(7), 744-755. https://doi.org/10.1080/0142159X.2020.1768230
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